Gut decontamination of critically ill patients reduces Helicobacter pyloriacquisition by intensive care nurses

The prevalence of Helicobacter Pylori is increased in healthcare workers an d in intensive care nurses. Exposure to H. pylori from gastric secretions a nd faeces are probably the main sources of transmission to healthcare worke rs. Routine use of selective decontamination of digestive tract (SDD) in an intensive care unit suppresses H. Pylori in critically ill patients. It wa s questioned whether this suppression and the subsequent decreased exposure to H. pylori for intensive care nurses would lead to a lower prevalence of H. pylori infection. Helicobacter pylori infection prevalence in intensive care nurses from a unit routinely using SDD (group I) was compared to that of nurses from a unit not using SDD (group II). Heathcare workers from oth er departments of the hospital where no SDD was used (group III) served as a control group. Persons using proton pump inhibitors were excluded. Helico bacter pylori was detected by Laser Assisted Ratio Analyser C-13-urea breat h test (UBT) and serology This could not be performed in three out of 64 in group I, five out of 55 in group II and five out of 55 in group III (total UBTs = 169). The prevalence of H. pylori infection was 11%(7/61) in group I and 25.5% (14/50) in group II (P=0.027). In group III, the prevalence of H. pylori infection was 16% (8/45), which was not significantly different f rom both group I and II. Sero-prevalence in group I was 18.6%, 27% in group II (NS) and 24%; in group III. Mean age in the three groups was 35.9, 37.8 and 36.6 years, respectively (NS). In conclusion, the prevalence of H. pyl ori infection among intensive care nurses is lower in nurses from a unit us ing SDD compared to a non SDD-using unit. Acquisition of H. pylori by trans mission from critically ill patients appears to be diminished through SDD u se. (C) 2001 The Hospital Infection Society.